As the tertiary centre in Northern Ireland, severely injured patients are transferred to Royal Victoria Hospital (RVH) regional ICU for further definitive management. Minimum radiology should be performed before transfer.

Thirteen patients were admitted from RVH ED, 25 from a DGH ED. Spinal injury was diagnosed in 7.7% in the RVH group versus 28% from the DGH ED. The median time to clear the cervical spine was 24 hours (RVH) versus 48 hours (DGH), and the thoracolumbars was 34 hours (RVH) versus 48 hours (DGH). See Tables 1 and 2.

Despite Advanced Trauma Life Support guidelines, plain X-ray scans of the lateral cervical spine, chest and pelvis are not routinely performed in all trauma patients. Not all spinal injuries are being detected by radiology performed in EDs. Significant delays in clearance of spinal injuries occur despite a protocol in place, exposing patients to other potential risks. The development of a critical care network in Northern Ireland should allow the standardisation of pre-ICU management of trauma patients.